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GP opening hours to be included in NHS review of urgent and emergency care

GP practice opening hours are to come under scrutiny as part of a national review of urgent and emergency care being launched by the NHS Commissioning Board.

The review - which forms part of plans to introduce more seven-day working across the NHS in England - will be led by the Board’s medical director Sir Bruce Keogh.

Sir Bruce recently told the Sunday Times that GPs should be prepared to work at weekends for the benefit of patients in an effort to emulate the customer service offered by Tesco.

He said that primary and secondary care clinicians should move towards seven-day working as the current system is designed for health workers and not patients.

In a statement the NHS Commissioning Board said the urgent and emergency services review team will work with CCGs to develop a national framework offer to help them ensure high-quality, consistent standards of care across the country.

It said the review will take account of the way that emergency care in England works with other areas of the NHS, such as GP surgeries, community care and the 24-hour NHS 111 advice line.

A Board spokesman confirmed to Pulse that the review team would examine the whole NHS - including GP surgeries and out-of-hours care.

The review team will publish emerging principles for consultation in the Spring.

In its planning guidance, published late last year, the NHSCB said it would order the review as part of plans for more seven-day services.

As well as seven-day working, the review aims to help CCGs find “the right balance between providing excellent clinical care in serious complex emergencies and maintaining or improving local access to services for less serious problems”.

It will set out the different levels and definitions of emergency care ranging from top-level trauma centres at major hospitals to local accident and emergency departments and facilities providing access to expert nurses and GPs for the treatment of more routine but urgent health problems.

As well as looking at how emergency care is provided, the review will also assess transfer processes between these levels of emergency care.

Launching the review Sir Bruce said: ‘The NHS is there for all of us and should offer appropriate, effective and rapid care whenever and wherever it is needed.

‘Treatments for many common conditions such as heart attacks and strokes have evolved considerably over the last decade and are now best treated in specialist centres. Yet we know people want their A&E nearby.

‘This makes me think we need to review the increasingly complex and fragmented system of urgent and emergency care, so that sick, anxious and often frightened people can get what they need when they need it.’

Readers' comments (19)

  • Oh great they'll be telling me soon:

    "Doctor, your 12 hours a day shift just isn't adequate, you should be working 24/7. By the way take a pay cut whilst you are at it will you....."

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  • Good idea but who is going to do it?? I am NOT working 7 days per week. This would need to be resourced direct from the government as extra funding. Does this lazy, pompous and arrogant man work 7 days a week?? "Sir Bruce" can **** ***

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  • Primary Care is not Tesco thank god?
    If we didn't have a constant stream of coughs , colds & winter vomiting there would be more than enough appointments in a normal 5 day working week.

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  • You want us to be more like Tesco. Does that mean we cut corners to the extent that our care become "horsemeat" too?

    Absolutely consumerist drivel

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  • This comment has been moderated

  • My local Asda recently stopped beng open 24 hours!!! Why? Making not enough profit of course. The is no comparison between tesco or asda & the NHS.

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  • welcome to 21st century NHS;M Leaving for Australia

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  • They took money away from us in return for relinquishing OOH responsibility. Now they realise that the alternatives they put in place are inadequate and want us back!

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  • Professional engineers, as well academically qualified as GPs, work shifts, for about half the pay that GPs get, in order to ensure that the lights stay on.

    Why should GPs not do likewise?

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  • In response to Terry Jones: your comparison of general practice to engineering is misguided.

    Engineering covers a wide range of professions from electrical or gas engineers to civil engineers... Not all of these are subject to equivalent academic training and professional development as GPs.

    Fixing an electrical fault or a problem with network cabling ( as examples) is not equivalent to health care. Our patients usually have a hierarchy of health concerns. They will usually seek medical advice when they perceive something to be important or serious.

    One patient with a headache will book an appointment fearing a brain tumour another may ignore it as probably nothing yet see the GP for his/her abdominal pain instead.... A patient's health agenda does not go away. Instead their priorities change.

    In the example above once the patient has had their headache assessed they may be reassured and this problem falls to a lower priority. They may then book another appointment to address their abdominal pain.

    This constant shifting of health priorities means that there is an almost infinite demand for GP services.

    This is the reason we cannot thin our service out over the week to a 7 day working schedule... The demand for appointments would not decrease over the weekdays. The very patients seen during the week would create demand for appointments at the weekend with (understandably) new health priorities.

    General practice is stretched to breaking point at present. GPs routinely work 12 or more hours per day and everyone I know is unable to finish the days's work in those hours.

    7 day opening would not reduce the weekday workload and as such would be unworkable. Some commentators have suggested that GPs should simply employ more doctors to create extra staff.

    As many have said already on this site, most GPs do not earn the sums that the daily mail suggests. To cut GP pay further would leave the profession open to market forces... That is future students and graduates will decide that the social/emotional cost of the job (never seeing your family, stress, increasing loss of autonomy and professional independence) does not match the economic benefit (I.e take home pay) and satisfaction derived from the practice of medicine... Recruitment to general practice will dry up and the system will collapse.

    .... Actually, never mind recruiting new GPs, the country may struggle to hold on to the ones it has already!

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  • Tesco gets more revenue by opening 7 days a week
    If your cost base increases this has to be met.
    I'm happy to work on any days in the week.
    But not 7 days a week .
    If this is not funded with a fair market profit
    On top... Tesco is allowed to make a profit...
    Then it will not work!
    If you want to change and improve access
    It will not and never be cost neutral .
    We as a nation are struggling with debt .
    So to implement this we have to think out of the
    box.
    New income streams required
    I do not know the answers but what about
    Considering
    1....charging insurance companies for all rta's
    2....All sports clubs/ individuals having insurance for injuries Nhs bills the insurer
    3.....All employers have to have injury at work
    Insurance

    These are just examples....
    Use the money raised to reinvest in the desired
    Changes???
    In the review lets hope they look to see if the added
    Costs equate to health benefits.. Convenience
    May not be affordable!

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